Many women have heard of the Plan B pill, but fewer have heard of Plan C.

Unlike Plan B or “the morning-after pill,” which is can be taken up to 5 days (per WHO) after unprotected sex or where there is a possibility of unwanted pregnancy (missed pills/patch/ring days), Plan C pills are abortion pills that can be used during the first 11 weeks of pregnancy.  Plan C is also called a “medical abortion” or a “medication abortion.”

With the recent overturning of Roe v. Wade by the US Supreme Court, there has been a flurry of changes to abortion law in this country, opening the doors for states with or without “trigger bans” on the procedure to enact further restrictive laws to abortion care. 

After the Dobbs v. Jackson Women’s Health Organization decision by the Supreme Court, which overturned Roe, demand for Plan C (medication abortion, abortion pills) has continued to rise, at the same time as Republican lawmakers look to further restrict access to abortion care moving forward. 

In this changing political climate, medication abortion is now critical to abortion care, abortion rights, and access. Pandia Health is here to help you by providing you with reliable women’s health information.

What is Plan C?

In 2020, abortion pills were used in more than half of abortions in the US, according to data from the Guttmacher Institute, a sexual and reproductive rights non-profit organization. 

Plan C, the abortion pill, is typically a combination of 2 medications:

  • Mifepristone (Mifeprex), and
  • Misoprostol (Cytotec).

Medication abortion involves taking 1 mifepristone pill, followed by 4 misoprostol pills 24 to 48 hours later. Mifepristone blocks the hormone progesterone needed to establish and maintain a pregnancy. Misoprostol causes your uterus to contract and push its contents out of your body, like a miscarriage.

If taken in the first 11 weeks of pregnancy, most women have a low risk of complications. 

What is a medical abortion? What is medication abortion?

Medication abortion is a non-invasive way to end a pregnancy. The medicines used in medication abortion pills work by blocking progesterone (a pregnancy hormone that helps maintain a pregnancy), relaxing and opening the cervix, and causing the uterus to contract, effectively pushing out the pregnancy. 

On day 1, you take one 200-mg tablet of mifepristone.

24 to 48 hours after taking mifepristone, place four 200 mcg misoprostol tablets in your mouth between your gum and your cheeks (2 on each side) and keep them there to dissolve for 30 minutes. After 30 minutes, swallow any remaining pieces with water. It’s important not to eat or drink anything during that 30-minute period to ensure that the medication is absorbed correctly. 

Your provider may prescribe additional misoprostol tablets, depending on how far along you are in your pregnancy. Your provider may also suggest you take the misoprostol by the vagina instead. (This option often has fewer side effects but might have leftover pill residue. In states where abortion is illegal, this is not advised.)

What you might see: It may look like small colored clots and thin membranes or a small sac surrounded by a white, fluffy layer. Depending on where you were in your pregnancy, the tissue that comes out can range in size from smaller than a fingernail to the size of your thumb. 

If you can identify these tissues, that’s an indication that the medication abortion was successful. 

Many women prefer Plan C over surgical abortions because it has similar effects to those of an early miscarriage and is less invasive and safer than surgery. Also, you can decide what day/time you want to do this vs. having to get to a clinic and fit their schedule.

Where can I get the Plan C pills?

While Pandia Health only offers Plan B emergency contraception, You can get the abortion pills as a prescription from your medical provider. Many pharmacies can fill prescription. 

Availability and access to Plan C vary by state. Depending on where you live, there may be restrictions for people 17 years old or younger. Some states have waiting periods to get an abortion. 

In some states, you can do your visit online and get your abortion pills mailed to you. 

There are 19 states that have prohibited the use of telehealth to prescribe abortion medication by requiring prescribers to be present when the Plan C pills are administered. 

The following states all still allow telehealth abortion services: Alaska, California, Colorado, Connecticut, D.C., Delaware, Georgia, Hawaii, Idaho, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and Wyoming.

Are telehealth abortion pills safe?

Medical abortion is safe. Serious side effects or problems are rare, but as with all medical procedures, there can be risks.

Medical abortion has been used legally and safely in the US for more than two decades. Serious complications can happen but are really rare. Complications can include:

  • The pills don’t work and the pregnancy doesn’t end
  • Some of the pregnancy tissue remains in your uterus
  • Blood clots in your uterus
  • Excess bleeding
  • Infection
  • Allergic reactions to the medications themselves. 

If you experience any of the above, you should contact your healthcare provider ASAP.

You should start to feel better the day after your abortion. If you feel sick with nausea, vomiting, diarrhea, stomach pain, or a fever for more than 24 hours after taking misoprostol (the second set of pills), contact your healthcare provider immediately. 

Buying and using abortion pills online without consulting a doctor or healthcare provider comes with the risk of using counterfeit pills. Safe, effective abortion pills should be:

  • White in color
  • Pills or tablets (NOT capsules)
  • Distributed in an undamaged double-aluminum blister pack
  • Sold to you by a trusted pharmacy or medical provider
  • Not expired

The US states considered “abortion deserts”

With the overturning of Roe, more than half of US states are almost certain or likely to restrict or ban abortion care and access. A 2017 study finds that half of US women lived within 11 miles of an abortion clinic, but about 20% of them have to travel 43 miles to receive care. In certain states where abortion is illegal (mainly in the Mountain West, Midwest, and Southeast), those travel times will increase drastically. Women in Louisiana and Florida may have to travel upwards of 400 miles to access an abortion clinic.

How Can Pandia Help?

To learn more about all things emergency contraception and medication abortion, check out our Instagram live with Dr. Sophia Yen, CEO and co-founder of Pandia Health, and Cindy Adam, family nurse practitioner and CEO of Choix, a telehealth clinic providing abortion and reproductive care. 

While we do not offer Plan C pills, we do offer Ella, which is an emergency contraceptive that works up to 5 days after having unprotected sex, and Plan B which works within 3 days of having unprotected sex. Get emergency contraception in the mail and delivered free from Pandia Health. It’s never a bad idea to have it on hand just in case!